tci Medicare Compliance & Reimbursement - 2017 Issue 15

Compliance: Avoid Fraud Problems By Understanding These 3 Fraud Laws

Hint: Though they both deal with referrals, Stark and AKS are not the same. As the OIG and their cohorts home in on criminals who abuse CMS and its programs, the need for a greater understanding of the nuances of Medicare fraud increases, especially if you want to avoid the heat. Refresher: There are three main areas of concern where providers may unwittingly violate the rules: The Anti-Kickback Statute (AKS); the Physician Self-Referral Law, more commonly known as the Stark Law; and the False Claims Act (FCA). The AKS and the Stark Law focus on referral issues, but the...

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